Cholera is a serious and sometimes life-threatening infection that
mainly affects people in developing countries, where clean water and
other sanitation measures are hard to come by. If you live in the United
States, the chances of someone in your family getting cholera are slim. But if you're planning to travel to a foreign country, especially one
in the tropics, it's a good idea to know about cholera, and how to
prevent it. Taking precautions with your food and water is the best way
to avoid the illness.

About Cholera

Cholera is an intestinal infection caused the bacterium Vibrio cholerae.
This bacterium produces a potent toxin that binds to the walls of the
intestines. The body responds by secreting large amounts of water,
causing watery diarrhea, vomiting, and subsequent dehydration as fluids and salts exit the body.

As a result, people with cholera can become dehydrated very quickly.
Untreated severe dehydration can cause serious health problems like
seizures and kidney failure. A person who doesn't get the proper medical
treatment might even die. The good news is, cholera is easy to treat if it's caught early. Kids
who have mild to moderate cases usually get better within a week. Even
people with severe cases of cholera recover fully in a week or so if
they get medical care.

Cholera is mostly found in hot, tropical climates — in particular
Asia, Africa, Latin America, India, and the Middle East. Although it's
rare in the United States (the last outbreak was in 1911), cases can
still occur. Travelers from countries where cholera is more common can
bring it into the country, and some people in the U.S. have become sick
from eating raw or undercooked shellfish from the Gulf of Mexico.

How It Spreads

People get cholera from eating or drinking food or water that's been
contaminated with the feces (poop) of someone who has cholera. This is one reason why cholera is rare in countries with good
sanitation systems. Things like flush toilets, sewer systems, and water
treatment facilities keep poop out of the water and food supply. Cholera
epidemics also sometimes happen after a disaster (like an earthquake or
flood) if people are living in tent cities or other places without
running water or proper sanitation systems. Less commonly, the bacteria
that cause cholera are found in brackish rivers and coastal waters. Cholera is not contagious, so you can't catch it from direct contact with another person.

Signs & Symptoms

When someone is infected with the cholera bacterium, symptoms can
appear in a few hours or as late as 5 days later. Many kids with cholera
have no signs or symptoms, but some cases can be severe and life
threatening.

Common symptoms of cholera and the dehydration it causes include:

watery, pale-colored diarrhea, often in large amounts

nausea and vomiting

cramps, particularly in the abdomen and legs

irritability, lack of energy, or unusual sleepiness

glassy or sunken eyes

dry mouth and extreme thirst

dry, shriveled skin

low urine output and a lack of tears

arrhythmia (irregular heartbeat) and low blood pressure

If your child develops symptoms like these, especially after visiting
an area where cholera is likely or common, call your doctor or get
medical help right away. Severe dehydration can happen very quickly, so
it's essential to start replacing lost fluids right away to avoid damage
to internal organs.

Diagnosis

To confirm a diagnosis of cholera, doctors may take a stool or vomit
sample or a rectal swab to examine for signs of the bacteria. Rapid,
dipstick-style tests are now available, which help health care providers
in remote areas identify the disease more quickly and control outbreaks
more effectively. All confirmed cases of cholera must be reported to
local health officials.

Treatment

Since severe dehydration and death can occur within hours, cholera
needs to be treated immediately. Most kids recover with no long-term
problems as long as they receive prompt treatment. The goal of treatment is to replace all the fluids and salts lost
through diarrhea and vomiting. For mild dehydration, a doctor may
recommend giving your child an over-the-counter rehydration solution.
Kids with more severe cases of cholera may need to stay in the hospital
and get intravenous (IV) fluids.

Sometimes doctors prescribe antibiotics to treat cholera. The
antibiotics are not as important as rehydration, but can help shorten
the length of time someone is sick. They also might make cholera-related
diarrhea less severe. Sometimes doctors also prescribe zinc
supplements. Anti-diarrheal medicines can actually make the symptoms of cholera worse, so if your child has cholera (or you think your child has it), do not offer them.